The incumbent is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. The C&P Specialist is aligned to and supervised by the C&P Manager.

Duties

The incumbent assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Serves as SME in the field of credentials and clinical privileging. Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the C&P process. Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to the supervisor for guidance. Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Manages provider applications (initial and renewals) for LIPs C&P within the VAMC. Incumbent must have a broad knowledge of medical specialties and core privileges and is the technical advisor to clinical leadership for the development of department specific privileges and assures that complete documentation is available to support privileges granted to providers within their training and/or experience. Provides guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board certifications. Primary source verification includes, but may not be limited to, the American Medical Association, NPDB, state licensing agencies, specialty certification boards, universities, DoD and healthcare facilities. Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements. Communicates with LIPs to assure timely completion of applications and VetPro requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations. Determines processes for coordination of incoming data and documents from a variety of sources. Documents include, but are not limited to, VA applications for employment, primary source verifications of education and training, peer recommendations, licensure, DEA license, board certification, NPDB CQ reports and personal history, and malpractice claims, FPPE, OPPE, etc. Reviews documents and applications for omissions and inconsistencies and assures data entry is complete and accurate to meet VHA policy and regulation, and TJC standards. Reviews documents received and determines course of action based on information provided within documents. Contacts provider for omissions and/or inconsistencies in information; initiates primary source verification of credentials. Analyzes and manages issues related to documents that do not meet expected requirements, regulations or guidelines such as malpractice claims, adverse actions against licensures and/or certifications, FSMB reports, and National NPDB CQ reports. Independently selects appropriate method of validation based on approved sources. Determines new methodologies to primary source verification as appropriate according to TJC standards. Performs other duties as assigned. Work Schedule: Monday through Friday 8:00am - 4:30pm Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist ( Credentialing and Privileging)/ 99876-S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement. 10/23/2023. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-9 position you must have served 52 weeks at the GS-7. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. Individual Occupational Requirements: Applicants who meet the Individual Occupational Requirements described below are fully qualified for the specified entry grade and must also meet the specialized experience requirements. Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems. Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR Special Provision for In-service Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements. Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. For the GS- 9 you must also qualify based on your experience as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Broad and thorough experience in pertinent laws, regulations, policies and precedents, accreditation standards and guidelines. Skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of the Credentialing and Privileging operations. Communicate orally technical information to a diverse group of individuals with varying levels of understanding. Professionally and calmly manage administrative functions and the flow of information in a medical center setting. Understands medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested. Communicate in writing to prepare emails, letters, reports and committee minutes. You will be rated on the following Competencies for this position: Attention to detail Compliance Customer Service Database Management Systems Problem Solving Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements: The work is primarily sedentary; although, some slight physical effort is required. Work may be performed in a clinical setting to observe program operations and trainee work environments. Some work may require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. Stamina and concentration to meet crucial deadlines is required. There may be a certain amount of pressure due to time constraints. There is extensive use of computer systems. Occasional travel including site visits to other VHA field sites and academic affiliates is required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address Lexington VA Health Care System 2250 Leestown Road Lexington, KY 40511 US
• Name: Michael Helton
• Phone: 615-582-2884
• Email: [email protected]